Tourette's syndrome: symptoms, treatment, causes, prognosis
What is this - Tourette syndrome is a specific psychoneurological disorder in which one or more different tics are observed in a person, in some cases supplemented by coprolalia, that is, uncontrolled shouting of abusive words.
It begins in childhood or adolescence in people with this genetic predisposition. More often than not, the severity of symptoms decreases with age.
Mental development with this disease does not suffer. Dangerous for life complications does not cause pathology.
What causes the development of Tourette's syndrome, and what is it? It is believed that the disease develops in people who own a specific gene( its exact location is not clear).It can be transmitted autosomal way: both dominant( more often) and recessive. Children with Tourette's syndrome have a 50% chance of "getting" a defective gene.
It is not known how pronounced the disease is, or a tick of an easy degree, or as obsessive and irritating thoughts without tics, perceived as own. It is believed that sex affects the severity of the disease: in men, it manifests itself more often.
In some cases, the disease develops in a person whose parents are healthy. The risk of developing the disease is greatly increased if during the pregnancy the mother took medications, anabolic steroids, suffered a disease accompanied by an increase in temperature or a pathology caused by the bacterium staphylococcus.
The syndrome does not start "from scratch", but after one or more events called trigger factors:
The characteristic symptoms in Tourette's syndrome are manifested in the form of various ticks, that is, involuntary movements, conditionally divided into two types: vocal( voice) and motor( motor).Each of them is simple or complex.
Tics in Tourette's syndrome are characterized by:
This is the reproduction of some repetitive sounds( coughing, snorting), noises, syllables or even whole phrases put into the sentence or used separately, arbitrarily, not necessary to explain the meaning of the sentence.
They may resemble a stutter or other speech defect. In this case, simple ticks will be considered the reproduction of noises, sounds or syllables, complex - if a person uses a whole word or phrase.
Vocal ticks are also considered: omission of an important semantic part of the sentence or emphasis on a word or a combination of them, not carrying a semantic load. Separate sound ticks( they are also called phenomena) are:
These are monotonous irregular movements that occur after the appearance in the brain of a dominant perform such a movement.
Dominant can be felt as a feeling of tension in the limb, after which the person starts to move it, a feeling of "sand" in the eyes, because of which the person is forced to blink, and so on. The motor tics can look like jumping, clapping hands, drawing yourself bodily injuries, indecent gestures, frowning.
Simple motor tics occur in one group of muscles( blinking, frowning, shrugging);complex - in several( touching yourself or others, hitting your head on objects, grimaces, biting your lips).Such movements can be extremely inconvenient to perform, because of them a person is forced to interrupt his previous activities.
Tourette's syndrome usually begins with the appearance of simple motor tics;has a propensity for progression: the tics spread from the head to the upper and then to the lower extremities, become complex, and soon they are joined by sound ticks and / or phenomena.
The greatest number and maximum expression is usually observed in adolescence, then the symptoms gradually regress. By the age of 20, there are usually minimal tics, but in 10% of patients the disease continues to progress, and may even lead to loss of ability to work.
There are no special tests to confirm the diagnosis. It is based on the following criteria:
Treatment of the disease is carried out by neuropathologists, psychotherapists and psychologists in specialized centers. In the easy stages of Tourette's syndrome, medication is not required:
Manifestations of the disease usually decrease after adolescence, without causing life-threatening complications and without affecting life expectancy.
An adult can have some manifestations of the syndrome( tics, coprolalia), as well as various mental disorders( depression, panic attacks, mood swings, antisocial behavior).
It begins in childhood or adolescence in people with this genetic predisposition. More often than not, the severity of symptoms decreases with age.
Mental development with this disease does not suffer. Dangerous for life complications does not cause pathology.
What causes Tourette's syndrome
What causes the development of Tourette's syndrome, and what is it? It is believed that the disease develops in people who own a specific gene( its exact location is not clear).It can be transmitted autosomal way: both dominant( more often) and recessive. Children with Tourette's syndrome have a 50% chance of "getting" a defective gene.
It is not known how pronounced the disease is, or a tick of an easy degree, or as obsessive and irritating thoughts without tics, perceived as own. It is believed that sex affects the severity of the disease: in men, it manifests itself more often.
In some cases, the disease develops in a person whose parents are healthy. The risk of developing the disease is greatly increased if during the pregnancy the mother took medications, anabolic steroids, suffered a disease accompanied by an increase in temperature or a pathology caused by the bacterium staphylococcus.
The syndrome does not start "from scratch", but after one or more events called trigger factors:
- , diseases triggered by a microbial factor( especially those caused by streptococcus: angina, scarlet fever, glomerulonephritis, rheumatism);
- stress;
- intoxication: alcoholic, poisoning by toxic substances;
- diseases in which the body temperature rises;
- receiving children of psychotropic substances( mainly, neurostimulating action) for the treatment of various neurological disorders.
- dopamine;
- serotonin;
- noradrenaline;
- acetylcholine;
- ɣ-aminobutyric acid;
- some neuropeptides: dinorfin, enkephalin, substance P).
Symptoms of Tourette's syndrome
The characteristic symptoms in Tourette's syndrome are manifested in the form of various ticks, that is, involuntary movements, conditionally divided into two types: vocal( voice) and motor( motor).Each of them is simple or complex.
Tics in Tourette's syndrome are characterized by:
- rapidity;
- with monotony;
- is irregular;
- full awareness of what is happening;
- the possibility of volitional suppression - only for a short time;
- previous strong motivation to perform a teak movement or sound( akin to the strong itch that tick helps to resolve);
- emotional experiences affect the frequency and severity of tics.
Vocal Ticks
This is the reproduction of some repetitive sounds( coughing, snorting), noises, syllables or even whole phrases put into the sentence or used separately, arbitrarily, not necessary to explain the meaning of the sentence.
They may resemble a stutter or other speech defect. In this case, simple ticks will be considered the reproduction of noises, sounds or syllables, complex - if a person uses a whole word or phrase.
Vocal ticks are also considered: omission of an important semantic part of the sentence or emphasis on a word or a combination of them, not carrying a semantic load. Separate sound ticks( they are also called phenomena) are:
- 1) Coprolalia - involuntary( before that a person feels the urge to do this) shouting of abusive or obscene words, expressions of a sexual, aggressive orientation, which are superfluous in this sentence and do not characterize the situation described by a person. This symptom occurs only in 10% of Tourette's syndrome, is not specific for this disease.
- 2) Echolalia - the repetition of other words or phrases taken out of context.
- 3) Palalalia is the repetition of one's own word several times.
Motor tics
These are monotonous irregular movements that occur after the appearance in the brain of a dominant perform such a movement.
Dominant can be felt as a feeling of tension in the limb, after which the person starts to move it, a feeling of "sand" in the eyes, because of which the person is forced to blink, and so on. The motor tics can look like jumping, clapping hands, drawing yourself bodily injuries, indecent gestures, frowning.
Simple motor tics occur in one group of muscles( blinking, frowning, shrugging);complex - in several( touching yourself or others, hitting your head on objects, grimaces, biting your lips).Such movements can be extremely inconvenient to perform, because of them a person is forced to interrupt his previous activities.
Tourette's syndrome usually begins with the appearance of simple motor tics;has a propensity for progression: the tics spread from the head to the upper and then to the lower extremities, become complex, and soon they are joined by sound ticks and / or phenomena.
The greatest number and maximum expression is usually observed in adolescence, then the symptoms gradually regress. By the age of 20, there are usually minimal tics, but in 10% of patients the disease continues to progress, and may even lead to loss of ability to work.
Diagnosis of Tourette's syndrome
There are no special tests to confirm the diagnosis. It is based on the following criteria:
- 1) Tics look like involuntary, non-purposeful movements that occur in one or more muscle groups.
- 2) Tics appeared before 20 years of life.
- 3) There have been at least a year.
- 4) The severity of the symptoms varies, which can be characterized as exacerbations and remissions.
Treatment of Tourette's syndrome
Treatment of the disease is carried out by neuropathologists, psychotherapists and psychologists in specialized centers. In the easy stages of Tourette's syndrome, medication is not required:
- psychotherapy;
- hypnotherapy;
- auto-training;
- cognitive-behavioral therapy;
- therapy of "biologically feedback";
- improvement of the moral atmosphere in the family;
- change the regime of the sick child's day: in the dark, prohibit watching movies or playing computer games, putting him to bed in time, excluding hikes at discotheques with bright sounds, stroboscopic effects and light music.
- antipsychotics are used: "Risperidone", "Haloperidol", "Truksal", "Pimozid";
- receptor blockers for dopamine: "Sulpiride", "Metaclopramide";
- alpha-adrenomimetics: "Clonidine", "Guangfakin";
- for obsessive-compulsive disorders use drugs "Fluoxetine", "Paroxetine", "Fluvoxamine";
- tricyclic antidepressants: "Selegiline", "Desipramine".
Forecast
Manifestations of the disease usually decrease after adolescence, without causing life-threatening complications and without affecting life expectancy.
An adult can have some manifestations of the syndrome( tics, coprolalia), as well as various mental disorders( depression, panic attacks, mood swings, antisocial behavior).